Getting Used to an Insulin Pump

Posts tagged ‘Exercise’

The … Diabetic

The ... Diabetic

The … Diabetic

I received an e-mail the other day relating to playing volleyball with an insulin pump and thought that the questions and my answers may be relevant, not only to volleyball but to a lot of other sports and activities.

I asked the nice young lady if she’d mind me using it for a blog post and she said that was okay as long as I used her pen name which is The … Diabetic, She writes her own blog (click on that link to get to it). I’ve also changed her e-mail address for the one she requested so feel free to contact her if anything on her pages floats your boat.

Date: Tue, 5 Feb 2013 14:43:08 -0800
From: the_3dots_diabetic@yahoo.com
Subject: Insulin Pumps and Volleyball
To: NottsType1@hotmail.co.uk

Hi Dan,

I came across your blog when doing some research on insulin pumps and playing volleyball. I’m quite interested in getting an insulin pump, but am only at the start of my investigations. I have an appointment with a Pump Doctor at my local clinic in a few weeks time, so I’m trying to do some homework beforehand and be prepared at the appointment!

I’m quite a keen volleyball player. I train 2 hours on 3 nights each week, I help coach juniors for 1 hour on one of these nights (before training), and play matches on a Saturday. Depending on the match schedule, I sometimes play on a fourth night in the week too.  I guess my main worry is how well infusion sets stay in place when jumping, blocking, hitting and diving, as well as how easy it is to avoid a pump getting damaged whilst throwing myself around court.  Would you be able to give me a bit of insight? Do you disconnect your pump? Have you had problems with air getting into sets or sets coming dislodged? From your blog, I gather you’re using a Roche Spirit Combo – has it been a positive experience? Where do you put it when on court? Finally, did you have to ask permission from the referees commision to play with a pump at matches?

Apologies about the million questions, there aren’t many testimonies out there of people playing volleyball with their pumps, and providing details on how they manage, so any extra insights would be much welcomed.

Kind regards,
The … Diabetic

My Response:

From: Type 1 Diabetic <nottstype1@hotmail.co.uk>
To: The … Diabetic <the_3dots_diabetic@yahoo.com>
Sent: Wednesday, 6 February 2013, 16:34
Subject: RE: Insulin Pumps and Volleyball

Alright The … Diabetic,

I’ve actually quit volleyball temporarily for a number of reason’s, none of which, I’m sure you’ll be pleased to hear, are to do with the pump!

So to answer your questions as best as I can:

1. My infusion set always stayed in fine while playing, I chose the Accu-Chek TenderLink when I started off pump therapy but have changed to the FlexLink, both of these have a flexible cannula but the TenderLink goes in at an angle which I thought would protect it better from bumps while playing, however I am on the thin side (about five foot eight (1.72m) and 10 and a half stone (65kilos)) and I found after a bit of use my stomach looked like a pincushion. The FlexLink ones are, in my opinion, if anything a little hardier and come with the added bonus of the Link Assist Insertion Device which works like a kind of staple gun to get it in to you (honestly, better than it sounds!!!). If you have a preference for which side you dive on it might be worth considering that when placing infusion sets but with the amount you play your probably better just to stick it in and see how it goes. Certainly reaching up for blocks and the force of hits seemed to have no effect on the set staying put!

2. I have a neoprene pouch with a loop to feed the velcro elastic strap that came with it through, not sexy but worked for me, however you sound like you play pretty intensely so it might be worth you looking at the hard case along with sports belts here. I wore my pump on my back turned so it ran vertically up my spine, more or less, so there was little chance of me falling on it, kept it on the whole time and didn’t have any problems with bits falling off or coming loose.

3. Keep it plugged in pretty much all the time, only time it comes off is when I shower or swim.

4. Never had problems with air getting in, they are pretty well sealed units, although when I got it I was warned that I should keep checking the tightness of where the pump connects to the cannula and I now do that pretty much as standard without even thinking about it.

5. The Accu-Chek Combo has been brilliant for me, although I suspect that there are probably better pumps out there already, I’ve had it nearly two years now after all. This site is pretty good for the latest info, but as above it’s probably worth checking what accessories you can get when trying to make a decision, it might also be influenced by your healthcare team but frankly I have a lot of friends on various pumps and no one has been disappointed!

6. Never even thought to ask the referees, although I did check with my coach as well as my Diabetes consultant, whether they thought I needed to consider taking any action other than what I had already decided (e.g. wearing it strapped on and on my back while playing) and they both said it should be fine.

If there is anything else I can help you with, Volleyball related or otherwise please drop me a line, I’m always happy to help.

By the way is it okay if I use your e-mail and my response in a blog post? I suspect this information would be useful to a lot of people!

Cheers

Dan

Web-Monkey
Nottingham Type 1 Diabetes Group
I’m Gonna Stick You!!!

Hope you all find that useful!

Toothbrush, Boots and a Memory Man

Boots The Chemist...and whatever else they do these days!

Boots The Chemist…and whatever else they do these days!

When I have a shower in the morning I tend to leave my insulin pump in my dressing gown pocket and then plug myself back in as soon as I’m dry and have something to clip it on to again. You may wonder why I’m telling you this, don’t worry hopefully it’ll become more obvious as the events of today unfold!

I was busy doing some important stuff at work this morning and I’d not bothered making any lunch as I thought I’d have a quick trip away from my computer to Boots in town to grab something. Because it had been busy I hadn’t done a  blood test since breakfast time.

So, one o’clock arrived and I headed out in to the frankly unpleasant weather, swiftly walking the five minutes or so in to try and avoid getting too damp. I got to Boots, picked a “”Delicious” Cheese & Pesto Pasta Salad”, a packet of healthy-ish crisps and a bottle of Diet Coke, then I headed over to the dental bit ’cause I need a new head on my electric toothbrush. I paid up and left heading in to the Victoria Centre to find somewhere to sit and have my lunch.

First thing I did was look at the food I had bought to see how many carb’s I needed to wind up on my pump, I was a little upset to find that Boots have re-branded their “”Delicious” Cheese & Pesto Pasta Salad” so it doesn’t actually tell you what the carbohydrate content is. After searching all over the packet many times I resolved to guess at the contents and adjust after getting back to a computer that I could look it up on (Web-Monkey without his own smartphone – funny I know!).

I did a blood test, as I always do before eating. I was a little surprised to find my BM was at 15.6mmol/l. “Hmm, that’s a little odd” I thought, that new bread must have a lot more carb’s in than it says on the packet. Anyway I wound up the CHO and hit the bolus button to which I was greeted by a “communication error” message. I cancelled out and tried it again and it did the same thing. Then I had one of those moments when you realise what the problem actually is. I patted myself down and realised that the reason I was getting a communication error was because my insulin pump was about two and a half miles away in my dressing gown pocket at home!

I ran back to work, carrying my carbohydrate-camouflaging salad, crisps, drink and toothbrush heads, grabbed my keys from my bag, excused myself and ran to get the bus home.

I got home in a little under fifteen minutes, which isn’t bad going, surprised Deanne who works from home on a Monday, plugged myself in and did a blood test, I’d dropped a little to 15mmol/l, which must have been a mix of the residual insulin and the running to get the bus. Gave Deanne a quick peck on the cheek and ran out the door again.

Getting back to work I looked up the “”Delicious” Cheese & Pesto Pasta Salad”, (56 grams in case you’re interested), wound up the total on my pump and bolused as quickly as I could.

Sadly after being unplugged for about six hours my blood sugar hasn’t yet normalised and I suspect if anything I’ll get a sudden drop at about six o’clock this evening.

When I had sorted myself out to my own satisfaction I posted a message on the Boots UK Facebook page, and to give them their due they actually told me they would look in to a way of including all the details on the back of the packet, you can see my overly sarcastic posting and their responses here if you’re interested.

Anyway, it was a stupid thing to do and closely aligned with last weeks stupidity of bringing my insulin to work ’cause I knew it would run out before the end of the day but forgetting to bring a cartridge in which to put said insulin!

All in all I seem to be having a couple of slow brain weeks, I’m hoping it won’t last much longer!

Ooh, Pointy!

When I was at the clinic the other week for my annual pump check up I asked if I could try a different infusion set, because my stomach looks a little like it has a bad case of acne from the places where the needles have been. My pump is an Accu-Chek Spirit Combo and I’ve used the TenderLink infusion set since I got it because I thought having the bit that sticks in to me at an angle rather than at 90 degrees would be better for e.g. when I was playing volleyball and such like.

Anyhoo, I was given the only one they happened to have a few of laying around which was the Ultraflex, this one has a needle which goes straight in to you but is much shorter and (I think!?!?!) thinner than the TenderLink. Anyway I got four of them and so I used them over the previous couple of weeks, then last night I went back to the old standard.

I have put a picture of both below, the old one on the left and the new one on the right and I just wanted to say that the old one now feels like trying to stick Cleopatra’s Needle in to myself. Sadly I have about three or four boxes of the TenderLinks left and I don’t believe in needlessly sucking money out of the good old NHS so I’ll use them up first but when I next give those nice people at Roche Diagnostics a call I’ll be changing my standard order to the FlexLink infusion sets!

Accu-Chek FlexLink Infusion Set

Accu-Chek FlexLink Infusion Set

Accu-Chek TenderLink Infusion Set

Accu-Chek TenderLink Infusion Set

Ban(ne)d

Tomorrow night I’m trying out with a band, they want a guitarist and I kinda play guitar…badly, or at least I used to about four years ago. Here’s a picture to prove it:

Me, Playing Guitar!

Me, Playing Guitar!

As I say I’m a little out of practice and probably need a few go’s before I can actually play along with their music so I’m hoping they’ll be patient.

Anyway last time I lived the rock ‘n’ roll lifestyle I was using a pen to inject four or five times a day, I didn’t do carb’ counting and I frankly managed my diabetes by crossing my fingers and having a lot of hypos and highs so I’m hoping it’s going to be a bit easier what with all this modern technology I’ve managed to persuade the medical establishment to supply me with.

However What I do have now is of course plugged in to my belly 24/7 and also has a three thousand quid piece of kit hanging off me, this is why I’m going to have to think carefully about my set-up before I head out of the house tomorrow night. I think I’m due an infusion set change tomorrow night so I’ll probably do that before I go, this means I need to pick a spot…and a side of myself that will cause the smallest inconvenience in terms of catching cannula on sticky out bits of guitar or continually rubbing said guitar over infusion set and causing discomfort.

Further to this is of course the fact that I have experienced most things which come up in every day situations since getting the pump, however I haven’t stood up for a couple of hours with a frankly rather heavy guitar (I own one of these now) which weighs about nine pounds, that’s about four kilo’s if you’re a youngster! Also there’s the unpleasantness of hefting guitars, pedals and even worse amplifiers up and down stairs to practice rooms and back to your car afterwards.

So with all these things considered am I having second thoughts about going tomorrow night?

Don’t be silly,  I’ll just do a lot of blood test before, during and after and hope Im lucky enough not to stab a finger so it hurts when I press the strings down, if I do I’ll just have to live with the pain. I’ll just make sure they are all aware that if I play particularly badly it may be a mixture of nerves, not having practised properly for about three years and low blood sugar all combined in to an ear splitting wall of feedback and noise. Or maybe that’s what they want???

Wish me luck 😉

Australia – A Really Badly Written Travelogue

Some Native Wildlife

Some Native Wildlife

In case you hadn’t realised Deanne, the Young ‘Un and I went to Australia for a month in March. This was partly to show the toddler off to the in-laws (Deanne is from Australia originally), partly because we hadn’t visited for five years and partly so we could all have a month off work/nursery and relax bit. I took the advice offered at the last Nottingham Type 1 Diabetes Group meeting by Dawn, she was rather handily (for me) talking about travelling with Diabetes. The main thing I was interested in, which she did actually mention was the fact that when she’s changing time zones she leaves her pump set on UK time until a few days have passed and she is more or less over the jet-lag. That may not be exactly what she said but that’s what I made it out to mean so that’s what I did.

The day of departure came and our bags were packed. My hand luggage obviously contained the requisite number of bags of Jelly Babies, a recently purchased Frio Insulin Travel Wallet (another suggestion from Dawn, thanks Dawn!), many, many infusion sets, insulin cartridges, blood test sticks and lancets and all the other Diabetes rubbish that we need to take when we go overseas. We arrived at Birmingham in plenty of time, which was lucky ’cause we had off site parking and had a bit of a job finding it, but then we got on the bus and it dropped us, with all our bags outside the main departures door at the airport.

The plane ride over was fine, although the service on the Birmingham to Dubai leg of the flight was less than we had hoped for, they (Emirates) hardly offered anything in the way of drinks (not talking alcoholic here, just water/soft drinks/etc.) and when the food eventually came they didn’t clear the trays up until about an hour later, which when you have a two year old makes doing anything in the already limited space available to you quite challenging.

Twenty odd hours after taking off we arrived in Perth. It was a bit of a change from the UK, it was about tea time when we arrived, eight or so hours ahead of the UK and the temperature was around 26 degrees (centigrade) when we left the airport. It was nice!

We actually went on a mini holiday the first few days we were there, drove a couple of hours south to Busselton which is a kind of hot version of Weymouth, only it’s nice! Being a bit further south the weather was nice but not too hot and we spent a lot of time going to chocolate shops and playing on the playground at the place we were staying at, it seemed to tire Deanne and myself out more than it did the Young ‘Un.

When we got back to Perth we had the important and serious task of meeting up with family and friends which included going to lots of parties and spending a lot of time sitting in coffee shops by the river. It was hard work! My control was relatively stable even though I was eating some pretty strange food. Certainly a lot better than the previous trip I had five years before where I was neither carbohydrate counting or dose adjusting (also didn’t have a pump at the time). Admittedly I had a few high blood sugars, seemingly for no reason although I worked out afterwards that it was actually due to ice cream cones which apparently had an awful lot more carb’s in than I was expecting (like 80 instead of 40 grams that I was guessing).

Me at Diabetes WA

Me at Diabetes WA

Anyway, once I had sorted that out everything went much better, I had a relatively low number of hypos and most of my blood sugars were below 12 with the exception of a few after meals out, however that happens to me in the UK too so it was nothing to do with being away. I even managed to do some Diabetes Web-Monkeying while I was away, I found a few bits and pieces in local papers and magazines which I posted on-line when I got the chance and also decided I’d go visit the local branch of Diabetes WA to find out what it’s like being Diabetic in Australia.

The main difference seems to be the fact that they don’t have a National Health Service, like what we do! Instead you have to take out health insurance which then covers the cost of a large percentage of the things you need as a Diabetic, e.g. needles, insulin, etc., etc., etc. They were very forthcoming and I in turn offered them some advice on how we use Twitter, Facebook and other on-line resources to keep in touch with people. It was interesting to speak to some people on the other side of the planet who have the same everyday problems and annoyances that we have over here.

After being on an insulin pump for over a year now my Diabetes certainly seemed to be a lot easier to manage and although I had highs and lows the way the pump adjusts them down and up again seems to be a lot more natural and my body seems to respond well to that, I don’t feel ill for hours after a high result and I don’t keep dropping and rising all day long like I did previously. I also feel like I can eat whatever I want while away and have almost got the hang of guessing carbs well enough to keep me fairly straight and narrow without needing to refer to my Carbs & Cals book all the time.

Now however I’m home again, in fact we got back about a month ago now and it’s taken me all this time to get this written down what with one thing and another including a Little ‘Un with chicken-pox, work, getting the house back to a manageable state after being away for a month and all those things you have to do upon returning from a long holiday.

The main difference between this trip to Aus’ and holidays I’ve had in the past is that whenever I’ve been overseas in the past I worried almost constantly about my control and about getting high or having hypos from having strange and exotic foods and experiences, this time however I didn’t worry, partly due to the pump, partly due to the fact that I have become a lot more confidant in controlling my diabetes with a pump than I ever was with injections and I guess mainly because when you have a toddler to look after you spend more time worrying about them than you do yourself!

We’ve already booked our next holiday in fact, we’re headed for Barcelona in the not too distant future, is there anything I’ll be doing differently because of my experiences down-under? Well no, the time away just went to prove to me that I am coping as well as I can with a chronic (/annoying) illness and all I need to improve even more is further practice. Which you only get by living it and doing things which you want to do rather than worrying about what might happen!

Unidentified Flying Illness

Unidentified Flying Bacteria

Unidentified Flying Bacteria

I’m Ill!

Okay that may seem like stating the bleeding obvious, however I’m not talking about my Diabetes, this is something new and frankly not super-comfortable. Let me tell you about it.

A couple of weeks ago we visited my parents in Dorset for the weekend, everything was fine until Saturday Morning when I started feeling a bit odd. Then at about ten or eleven in the morning I ran to the toilet and was ill. I continued to feel unwell for the rest of the weekend.

After getting home I forgot about it until the next weekend when I got a kind of pain under my ribs which lasted a good chunk of Saturday. We went to our neighbours’ house in the evening and frankly got a bit drunk, which was quite good fun, then on Sunday I didn’t feel great, which I put down to the alcohol I’d consumed, however I had a volleyball game on so I thought “self-inflicted, just put up with it” and played anyway (even with my ill-health and at-the-time-unrealised underlying health condition we won three sets to none – I actually played pretty well!!!).

Anyway, it got to Tuesday and as the day went on the pain under my ribs came back and I was having pains every time I took a deep breath in, coughed, sneezed or laughed…funny! I got myself to the NHS walk-in centre in town and got seen by a Nurse. Deanne had suggested it was Pleurisy but he discounted that because when he listened to my lungs they didn’t rattle, probably a good thing really.

After a bit of consultation he decided that it was possibly pancreatitis, caused by my recent-ish change in regime on to an insulin pump, he said this may have upset my pancreas due to the difference in my blood sugars and general control from being a bit random and bad to being quite well controlled.

This actually seemed to make a lot of sense to me but he said it was sensible if I went and saw my GP anyway so he booked me an appointment in the afternoon. I went and saw the GP and after a bunch of questions she decided that she wasn’t sure exactly what it was but that it may have something to do with my diaphragm and lungs or else something completely different so she gave me some pills called “lansoprazole” which seem to calm the acid in your stomach down so it doesn’t upset your other organs but sent me to the blood-letters at city hospital in the morning for a blood test just to discount the pancreatitis.

So currently I have no idea what’s wrong with me but still have pain and no idea when I’m likely to hear about my results.

Great!

In Bruges

Choco Story - A Chocolate Museum

Choco Story - A Chocolate Museum

We spent last weekend in Bruges in Belgium, a really nice place with lots of history and architecture and chocolate, all of which were nice!

The holiday got off to a positive start although the young ‘un was a bit unsettled on the trip over. We went by train from Nottingham to St. Pancr(e)as to Brussels and then caught another train to Bruges itself. It was quite a long trip what with all the waiting around for connections, he was really well behaved though.

Things were fine until we got there and got settled in then I did a blood test and it turned out I was 19.6 mmol/l…Oh dear, the next couple were higher at 19.9 then 21.3, in the morning I tested three times between half six and half eight and didn’t get under 10 on any of them. This was when I decided I’d change my insulin, infusion set and cannula, the next test I did two hours later at 10:40 was 3.3 so I’m guessing my suspicion was right and something was up with some aspect of my pump or my insulin.

The next day went pretty well and with most of my results being around 6 then on Monday another good day, I put it down to eating ice cream and chocolates!

Funnily enough the 23rd (Tuesday) was also pretty good but I did have one test out of the ordinary at 17.4 while travelling on the train again, I was worried that the Eurostar was having some kind of negative effect on my pump but my worries were unfounded as the next couple of tests were around 4.

Yesterday was our first full day at home and I came to work, dropping the little ‘un off at nursery, I decided that I would be good and start redoing fasting blood glucose tests so I started at 12 o’ clock and got the following results:

6.9 mmol/l

6.9 mmol/l

6.0 mmol/l

5.3 mmol/l

6.7 mmol/l

7.1 mmol/l

I figure this is close enough to no change for me to leave it alone so I will do my morning tests again next and then something which I have been putting off and off which is night time.

I’m pretty certain I need to do these as I am having more insulin at night than I need for my supper in order to get my BMs about right in the morning, I think this means that at some point at night my blood sugar is going up and therefore I need more insulin, working this out shouldn’t be too hard it just requires that I get up through the night and do blood tests every couple of hours.

Anyway I’m signing off again now, sorry about my lack of communication recently but I’ve been doing some coursework for a thing I’ve been doing at work, however I’ve finished this now and therefore will hopefully get a bit of spare time back in order that I can start putting a few more updates on here again.

A Long Afternoon

A Big Clock

When's Home Time???

This afternoon has been a very slow one to pass, as you can probably tell from the title I’ve given this post, however on the bright side it’s nearly over now!

Part of the reason it has seemed long is ’cause I’m doing some frankly not super-interesting stuff, however the other reason is that I have been quite low twice, a 3.3 mmol/l at 13:35 and a 2.7 mmol/l at 15:16. “Why so low” you ask? To be honest I have no idea, I had my lunch at about 11:30 in the morning (a habit I picked up many years ago when I worked with my Dad) so the one o’ clock test was two hours after lunch and then the three o’ clock one was after a particularly dull meeting.

Because one of the team bought in some gingerbread men I also had one of those after the last couple of Jelly Babies, at 7.8 grams of Carbohydrate it’ll hopefully be enough to keep me going without sending me sky high.

Anyway I thought I should give a quick update on how life is going as I have been a bit busy at work lately and not really had the time to craft my prose on all things Insulin Pump.

It’s been over four months now since I first got plugged in, it has been  a fairly steep learning curve since day one but it is now a part of my normal day to day life and doesn’t really cause me any problems as far as changing  the infusion set or filling up and putting in a new vial of insulin (which I just had to do at my desk at work!).

My control is obviously only as good as my guessing of carbohydrates and for the most part it doesn’t seem to be going too badly, for instance I had a HbA1C test a while back which tells you how your blood sugar average has been over the previous three or so months and it came out at 7.0 mmol/l. This is fantastic and I believe the best result I’ve ever had for one of these.

I’ve also pretty much come to terms with doing exercise while plugged in, at volleyball now I tend to eat about 12 jelly babies (around 60 grams of CHO) over the course of a two hour training session and that seems to keep my blood sugar fairly steady.

I still haven’t got round to doing all my fasting blood glucose tests, partly because I have been lazy but mostly because it is hard to guess when a good date will be for waking up every two hours in the night when you have a hectic lifestyle and a 15 month old baby, however I really must try and do at least one before my appointment to see the consultant in September in order that I can get as near as possible to perfect. I know almost certainly that my blood sugar goes up at some point in the night because when I  wake up in the mornings I tend to be hovering around between about 8 and 14 mmol/l, even if I haven’t eaten anything prior to going to bed with a 5 mmol/l.

Of course whatever happens I am still Diabetic and therefore my control will never be perfect but all that means is that there is always room for improvement and work on my control.

I feel like I’m rambling now so I’ll bid you adieu and write again some time soon when I’ve gathered my thoughts.

One last thing, I recently wrote a short article for the Nottingham’s NCT (the UKs largest charity for parents) Newsletter, I have scanned this in and posted it here if you are interested in reading something totally unrelated to Diabetes that I wrote!

 

In the words of the Cat: “what is it?”

Insulin and Carbohydrate

What Happens to Carbohydrate with Insulin

Okay, I’ve had enough of what I’m meant to be doing at the moment and anywhere to get a drink or something to eat has shut so I thought I’d start on my A-Z of Diabetes, or at least trying to give a bit of background on what it is and what all the things I talk about mean so…

Type 1 Diabetes, also called Diabetes Mellitus is an autoimmune disease, that is it is a problem with your immune system, in my case I believe I got a virus of some sort when I was about 22 months old, my white blood cells killed off the virus but then didn’t know where to stop and decided that my beta cells in my pancreas were also BAD so they started destroying these as well!

Beta cells have a few roles but the most important of these (to a Type 1 Diabetic at least) is that they pump out insulin and (sort of) glucagon. Both of these hormones have an effect on carbohydrates, insulin turns carbohydrates in your blood stream in to energy which your body can then use to power itself, glucagon turns stored energy, e.g. fats, etc. in to energy if you don’t have enough carbohydrate in your blood stream when you need it.

Obviously you need energy to power pretty much anything you do, if you do not have enough then parts of your body can start malfuctioning! This is called “low blood sugar” or a “Hypo”. I have experienced a whole gamut of different types of hypo and personally find they tend to be different dependent on what I’m doing at the time, for instance if I am exercising, not necessarily full on cardio-vascular body pummeling, can be as low impact as walking (or more likely these days pushing a pushchair!) then I will tend to have a muscular hypo, that is some muscle group in my body, possibly all of them, won’t have enough energy and therefore I’ll get wobbly legs or arms or possibly collapse on the floor or else not be able to get out of a chair.

Worse for a number of reasons are hypos that occur when I am thinking hard, e.g. writing a document at work or doing a brain intensive DIY task, in these cases the organ in my body using the most energy is my brain and so when I run out of energy my brain ceases to function properly. The reason this is particularly bad is because my brain, being short of energy, is often unable to realise that it is short of energy and so I miss the signs I would normally pick up and just get lower and lower until (on occasion but not so much these days) I become unconscious, it can also cause bad moods, arguing (more than normal) and a general change in personality. If it is one of these ones the best thing to do is just to tell me it’s a good idea if I do a blood test, I might well argue but if I do too much you can just leave me until I collapse and then call an ambulance 🙂

So, because I am unable to produce my own insulin I need to somehow get insulin inside my body, over the years this has been by syringe and needle, plastic syringe, pen injector and most recently an insulin pump (hooray), all of these devices do pretty much the same thing but to different degrees of control, syringes were okay but you simply sucked up as much insulin as was required by eye and injected it, insulin pens were a bit better as you wound up the dose and it would give you the same dose, standardised, each time you wound it up on the pen so you knew you were getting exactly 10 units if that is what you selected. I’ll come to the pump in a minute!

Of course to control the level of insulin you are giving yourself you also need to find out how much carbohydrate is in your body, originally when I (in fact my Mum and Dad) had to do this you had to catch some urine in a test tube and add some water and a pill which would then change colour to give an indication of how “sugary” I was, e.g. whether I needed to exercise to try and bring my blood sugar down or if I needed to eat something, they were pretty much the only options available back in 1976. Then they bought out dextrostix, which were plastic sticks with a reactive piece of chemistry on the end which, again, changed colour when you wee’d on it, somewhat simpler and less prone to accidents or mistakes in the process. Nowadays I have a blood test monitor, this involves pricking my finger with a lancet to draw some blood, this blood then goes on to a strip, not a world away from the Diastix I used to use but plugged in to a machine which then gives a reading as to your blood sugar, this has a number of advantages!

The old Diastix used to have a number of colours for the different readings, I believe that “blue” meant your blood sugar was between 0 and 9 millimoles per litre (mmol/l the standard unit of measurement until fairly recently) green was between 9 and 12 (or something like that, it was a long time ago!) and then a range up to brown which was frankly much too sugary! Bearing in mind that a normal blood sugar is meant to be between 4 and 8 it obviously didn’t give a lot of fine control over your blood sugar. Also it meant whenever you wanted to test your blood sugar you needed to be able to pee…and find somewhere to pee! Finally because it takes a while for your body to process carbohydrate and eject it the tests were always about an hour or two behind where your body was currently at.

Blood tests are more or less instant, you still have to carry kit about with you but no longer need to find somewhere private to test and the results are to 0.1 mmol/l, in this way my average blood sugar results have come down from somewhere between 9 or 12 to about 7 these days which is obviously desirable and in fact makes me feel much better about myself.

So these days I need to do blood tests to check my blood sugar, guess the amount of carbohydrate in food I am eating and adjust my insulin accordingly (a bit more about insulin types another day).

The pump is a fantastic device, it is programmed with the amount of insulin I need to deal with 10 grams of carbohydrate (CHO) and the amount I need to bring my blood sugar down by 1mmol/l (0.3 units I think) and when my blood test monitor tells the pump what I am eating (which I program in to it) and what my blood sugar is it decides how much insulin to give me for the food and to adjust my blood sugar to the right level and then pumps it in to me! Technology is fantastic.

That’s it for now, gotta go. I’ll continue this another day, feel free to ask questions if you want more info about anything I’m talking about and remember these are my views and opinions and probably wrong on a number of counts!

Feeling Better

12 Jelly Babies

12 Jelly Babies

Got to dinner time on Wednesday and was 2.1mmol/l…which is obviously low so it was at that point that I stopped giving myself extra basal insulin and the illness setting!

Thursday went pretty well, admittedly I woke up a bit high in the morning and my next blood test after that but after that I was between 5.8 and 7.6 for the rest of the day, including after volleyball, once again I didn’t try adjusting what I had with dinner I just ate 12 jelly babies over the course of the session and that seemed to do me fine!

I did however use the exercise setting when  got home and had supper, I normally have about 8.2 units for supper, my adjustment dose was -0.1 and the exercise setting removed another 2.4 units of insulin, I did this because I have woken up a few times after volleyball with blood sugar verging on the low side.

So I woke up this morning and did my blood test and I was…

13.7!

Hmmm, back to the drawing board I think.

Long Weekend Ahoy

Bank Holiday Forecast

What will probably happen this weekend!

I’m quite cheerful this afternooon because I’m off work until Wednesday because the University likes to extend alot of bank holidaysso we can get away from the students for a bit longer.

Yesterdays fasting results did not drop like a rock after five, in fact the last two were a 6.3 and a 9.2 so I’m not sure that really tells me anything other than I don’t really know what’s going on!

Volleyball was good last night, didn’t use the exercise setting or a temporary basal rate, I just had 6 Jelly Babies over the course of the evening and ended up with a BM of 7.8 at the end of the session, rising to 9.9 by the time I got home and had supper half an hour later so maybe didn’t need that many?

Anyway, it’s pretty much time to go home for me and I have a couple of things to do before I go so I’ll bid you all a good bank holiday weekend and speak to you again next week.

Perfect 5

Five

Will my blood sugar drop at five?

Didn’t manage the fasting yesterday either but I’ve been doing it this afternoon and it’s looking quite promising so far, all tests have pretty much been around the 5mmol/l mark so that is fine. It’ll be interesting to see if it drops at the 5 or 6 o’clock tests?

Not sure if I’ll make it to volleyball tonight as Deanne is travelling home from a meeting and isn’t likely to get home until 7:30 or 8.

Only other thing is that I tried leaving the old infusion set in for an hour on Tuesday night but still woke up at 14.4mmol/l on Wednesday morning so I either need to leave it in longer or just do a blood test and have an adjustment dose before I go to sleep after a changeover.

Infusion Set Fun

Infusion Set Drawing

A Drawing of an Infusion Set

Well I changed my infusion set last night, usually I would do it just before or after supper time which would mean I wouldn’t have a couple of hours before I went to bed so couldn’t then take the used one out afterwards. So I changed it at about eight o’clock.

Things seemed fine initially I did a blood test at twenty past eight to see how it was going and I was 6.7mmol/l…all good so far. I waited until nearly half nine before I did another blood test and was mildly surprised to find out I was 2.7mmol/l. Oh dear! So I took the used infusion set out then and there and I think the next time I change it I will try leaving it in for less time after the changeover.

Todays been fine so far, no hypos and the highest result has been 9.4mmol/l so I’m feeling pretty good about that. I’m doubting it has anything to do with the infusion set change last night though because I had to have a few jelly babies and then have my supper after the blood test so goodness knows what that did to my overnight blood sugar?

Volleyball tonight so I’ll probably say something about that tomorrow, going to try keeping my mealtime dose the same as normal (e.g. not adjusting for exercise) and then eating while I’m playing again like last time.

My Eyes, My Eyes!!!

Tropicamide

1% Tropicamide

This afternoon I went for my Diabetic Retinopathy screening at Boots in town, therefore if there are any spelling mistakes in this it is down to the fact that I can’t actually read what I’m writing because the 1% tropicamide has taken effect and everything is blurry and bright.

I don’t have a great deal to say following on from the essay I wrote yesterday, what I do need to do is start preparing my talk for the Notts Type 1 group in three weeks time otherwise I’ll just end up jabbering on about whatever comes in to my head and that could be very dangerous for everybody who attends.

Oh yes, there was one thing which was possibly useful that I was told at my EDWARD follow up yesterday, looking through my blood test results it looks like I am invariably high the morning after I have changed my infusion set, it was suggested that other people have had this same problem and the way to overcome it is to leave the previous infusion set in for a couple of hours after swapping over…

I can’t really see how this works because there is nothing (e.g. no pump) pushing the remaining insulin from the infusion set in to you but being an open minded sort of chap I’ll give it a go and see if I get better post change results.

My next change is on Thursday night which is volleyball night anyway so not sure if that’ll give me a sensible post change result but I’ll try and remember to keep my eye on my post change results the next few times I do it and update you on whether it’s helped.

Busy

Busy

Busy, Busy, Busy!

In case you were wondering I’m kind of busy at work at the moment which is why I’ve been a bit quiet, blog-wise! Thankfully I’ve managed to steal a few minutes this afternoon to post an update.

I think the last time I wrote anything I was still having high blood sugars first thing in the morning and was wondering if it was something to do with my extended time off work. Well it looks like it was because I am now back to where I should be with my morning BMs, which is good.

I had a strange night last Thursday at volleyball because didn’t drop my basal rate I just had about three lots of 20 grams of carbohydrates and was fine throughout the practice and the night afterwards. Think I might try this again this week, although the season and practices are nearly over so I will then need to remember this stuff until we start back again in a couple of months.

Went to my EDWARD 12 month follow up course today, I’m quite pleased because my HbA1C test came back at 7.0mmol/l which is frankly better than it’s ever been, Admittedly my previous results were 7.8, 7.6 and 7.8 again but the main reason for that was the number of hypos I used to have, pretty sure it’s gone down or at the very least they aren’t as severe as they used to be as I seem to get warning signs in the high 3s now rather than under 3.

I built and installed a raised bed in the garden yesterday, excitement central at the Ladle house, but the reason I mention it is because I didn’t have a hypo even though it was quite good body and brain exercise. There was however a fair bit of swearing, even though I have vowed to stop, the only times I seem to swear now is while doing DIY or volleyball, personally I think that’s excusable.

Last (but obviously not least!!!) for anyone interested I will be doing a talk at the next Nottingham Type 1 Diabetes Group meeting on Tuesday the 7th of June at 19:30 at the YMCA on Mansfield Road. I have entitled the talk “A rambling session from Dan about his life with Diabetes and obtaining and operating an insulin pump“. I think that may perhaps be overkill in terms of wordcount for the title of a talk but I asked Alex and she didn’t disagree so that’s what it is. I will be talking about my life up to now with Diabetes along with information on how I managed to persuade the NHS to give me an insulin pump and how my life has been since getting it. Feel free to come along if you are interested.

That’s it for now, back when I get some more spare time!

Holiday Time, Sort Of!

An Umbrella

Not that Kind of Holiday Sadly 😦

After today the updates may be a bit intermittent for the next couple of weeks as I am not at work for a bit. However I’ll do my best to keep updating every now and again until normal service is resumed.

My blood tests yesterday afternoon did not finish as I expected staying pretty much where they started for the rest of the tests, even going up a bit towards 6pm. I believe the reason for this is because once again I’m not entirely well, I have a sore throat, a cough and am apparently snoring like a herd of Aberdeen Angus (sorry Dee)! What with this and my annual leave I’m going to leave the fasting blood tests until after I’m back at work again.

I also badly misjudged the amount of mashed potato I had served myself at dinner time last night and ended up with a blood sugar around 18mmol/l which just goes to show that you’re much better to check if you’re not sure, which I wasn’t!

My time off work is going to be spent doing a variety of things including trips to Dorset and Cornwall, another (final) birthday party for the Little ‘Un and a host of DIY tasks at home so it should be a good test of my pump management skills.

The party should be good as all three of my brothers are making it, even the one who lives in Brazil, so it’s a nice way to celebrate my son’s first birthday, even if it is nearly a month after his actual birthday. There will be cake and chocolate and all manner of interesting foods.

Talking of tasty food I don’t think I’ve mentioned it before but Deanne is from Australia and with it being ANZAC day we should be having ANZAC biscuits on Monday (the 25th of April) so I need to figure out how much carbohydrate they have in them, not such an onerous task really 😉

Volleyball tonight should be okay, I’m feeling a little more confident about how to not have hypos and not get too high while playing now but I shouldn’t get too complacent because that is always when things go wrong.

I’ve also got the Nottingham Type 1 Diabetes Group website fixed and have updated that, including details of the talk I will be doing on the 7th of June on how I went about getting hold of my insulin pump and then how I’ve been dealing with adjusting to having it so be sure to check that out and keep the date clear in your diary.

So for the time being I’ll sign off and until I’m next on-line I’ll bid you farewell and have a nice bank holiday.

By Golly I Almost Have It

Dextrose Tablets

Dextrose Tablets

As mentioned yesterday I had a volleyball game last night, it was quite a good game as it was the last in the season and we beat one of the better teams in the league by three sets to none 🙂 however more exciting than that was before the game my blood sugar was at about eight and after the game it was about the same.

I was kind of expecting to drop to be low when I woke up this morning but it was about nine and a half so if anything I could probably have had a full dose instead of setting it for exercise when I had my supper after the game.

In other news I’m going to attempt to do my afternoon fasting blood glucose again tomorrow because I just did a blood test and was 3.4mmol/l which is obviously a bit low. Therefore please excuse any spelling mistakes that may be included in this particular post until the dextrose have kicked in 😛

Hopefully I can get to a stage before too long where I can stop having the afternoon hypos but of course being Diabetic I guess that there is no way you can permanently avoid them unless you run high all the time which causes more long term issues and complications than being low. Just one of those Diabetes things that people without it probably can’t really comprehend. Talking of which I’m considering what my options are in terms of future posts on the blog? I will definitely keep posting information about how the pump is going but would like to invite suggestions as to what other Type 1 based things people might like me to write about. I have a veritable cornucopia of experience having had Diabetes for nearly 35 years now so feel free to post your suggestions.

However I might not start diversifying with my topics until after I’ve spoken at the next Nottingham Type 1 Diabetes Group Meeting in June (I think!?) as otherwise I might run out of material for that :-S

Bats, Alcohol and a Garage

A Bat

A Bat

Sorry if they were helping you to keep track but after Ben commented last week that he thought a blood test monitor didn’t even go up to 42 I have decided to stop using the numbers at the start of each post 😉

Friday night was fairly quiet, Deanne was out at Nottingham University attending a talk on bats, which meant I had the night in on my own so I did a bit of house tidying and a bit of painting. probably not the most exciting evening but my control was fine and it meant I had something to do for the night.

Saturday however was a different matter, had a fairly late morning only getting up at 8am, we went for a drive round some furniture shops to try and find a wardrobe for the Little-‘Un’s bedroom, found a suitable candidate but it was obviously pretty hard work ’cause I was low by half twelve. had some friends round in the afternoon so mainly just sat around chatting and playing with the babies.

In the evening however I went along to the Nottingham Type 1 Diabetes Group night out at Fat Cat’s bar in Nottingham. It was a good night and a lot of people came along, it was nice to meet everyone and have a night talking about all things Diabetes related including pumps, injections, hypos, and many other things too diverse to mention. If you didn’t make it then you missed an interesting evening.

It did however mean that I had a number of beers, which I haven’t done since starting the pump, unlike the wine I normally drink beer does actually contain carbohydrates which meant that when I did a blood test at half eleven my blood sugar had gone up to 10mmol/l, not hugely high but higher than it should have been, therefore as a future note to self “if I’m drinking beer I need to do more blood tests”!

Went home and had supper and was fine but when I got up the next morning I was low at 2.5mmol/l so apparently when I adjusted at near midnight I hadn’t taken in to account the drop that invariably comes after drinking. Oops!

Sunday was mostly spent tidying the shed in our back garden. The best bit of which was that I actually finished doing it and now have a useable space in which we can find things when we need them and keep things while we don’t. Was quite pleased with myself as I managed to only go low once while I was doing the thinking/physical exercise that the job involved, survived by eating occasional packets of crisps and having the odd chocolate cookie with an exercise adjustment.

Tonight I have a volleyball match which I’m hoping I’m going to manage better than the one I had last week but only time will tell.

Forty Six – Volleyball-A-Go-Go

50 Percent Off

50 Percent Off

The change to my basal rate in the afternoon seemed to work okay because yesterday I was 3.7mmol/l at about 6pm and having just done a blood test I’m 4.8 which is a little low but not hypo at least! I suspect another couple of fasting afternoons may be necessary to get myelf completely sorted but I’ll worry about that when I get the chance to do them! I might also do some micro adjustments on my morning doses at some point to try and get the slight peaks I have later in the morning a bit flatter.

So, to the main issue, I went to volleyball last night and tried to manage my blood sugar using a mixture of the exercise setting on the pump, a temporary basal rate, jelly baby therapy and extreme violence (okay, no “extreme violence”, it’s a quote. Ten points to whoever can identify it first!). I dropped my basal rate to 50% and had an exercise dose for my dinner at 6pm. Got to volleyball at about 8 and started practice then realised I was feeling a little low by about quarter past.

I didn’t do a blood test just had four jelly babies, followed five minutes later by another four ’cause I was still feeling a bit light headed, after that I just played on! Did a blood test at about 9:40 and it was 5.5mmo/l which is a lot better than any previous attempts I’ve made to control myself through the rigours of volleyball. Did another test at about quarter past ten after finishing and it was 4.4, had some supper and again set the exercise dose on my monitor.

Woke up this morning and I was 4.9mmol/l which is AMAZING!!!

So next time I might try having four jelly babies before I start practice and then another four after the warm up and see how I go from there.

So once again I’d like to thank the staff at City Hospital’s Diabetes Unit for all their help and encouragement, they are stars.

Forty Two – Don’t Panic…

Don't Panic

Don't Panic

Well that was wierd. I was suspecting my last couple of blood tests to head swiftly downwards yesterday afternoon but the last one had gone up from the relatively stable 6 or 7 that the earlier ones had been by nine mmol/l and I ended up on the last one at 15.0???

I do however think this is an abberation and so will be doing another afternoon fasting test before I think about adjusting my basal rate for the afternoons.

The volleyball match was okay but I only played one set and hideously overcompensated for my previous few sessions undereating and ended up pretty high (shouldn’t have mixed the jelly babies and fanta tropical drink!) but at least I know what I have to do now, it’s just a case of getting the doses of carbohydrates right for the amount of exercise I do.

Today has been okay although I had a bit of a low patch between 9am and 1pm but have been fine since.

Apart from that I have promised myself that I am going to stop swearing. I’m trying to go cold turkey but it’s actually a lot harder than it seems when you’ve worked in engineering and IT in your career. Some of the guys I knew in engineering used to know words that I didn’t even recognise or understand and had to look them up or ask someone else afterwards. These were then of course written in to my vocabulary and have been in common usage by me ever since.

I doubt this will affect my control but you never know, perhaps I’ll be more relaxed!

%d bloggers like this: